Penn Surgeons Use Completely Robotic Surgery to
Successfully Treat Prostate CancerState-of-the-Art Technology Puts Patients on the Road to
Recovery Sooner
and with Less Pain, Scarring, and Negative Side-effects

PHILADELPHIA, PA – Prostate cancer is the second leading
cause of death among American men. It is estimated that one in six males
will develop the disease during his lifetime. However, promising new treatment
options have been developed to help combat this threatening disease.

One of the most innovative of these treatments is robotic-assisted laparoscopic
prostatectomy (removal of the prostate). The University of Pennsylvania
Health System is currently one of only a handful of facilities
across the country offering this minimally invasive, high-tech treatment.
David I. Lee, M.D., a national expert in robotic surgery,
was recruited to Penn and named Chief of the Division of Urology at Penn
Presbyterian Medical Center, where the robotic prostate program
is based.

There are many factors that make robotics an exceptionally valuable tool
in the operating room during prostate surgery, for both the patient and
surgeon. “Perhaps two of the most-feared possible long-term effects
of a radical prostatectomy are erectile dysfunction and urinary incontinence,”
says Dr. Lee. “My specially-trained team and I have discovered that
by using the robotic technique there is greater nerve sparing, which provides
patients with the best chance for maintaining potency and continence.”

Robotic technology offers a number of advantages during surgery. For instance,
the robotic “arms” filter even minute tremors of the human
hand so to provide steadiness. The robot’s camera also provides
a three-dimensional, stereoscopic image of the body’s interior,
as opposed to a two-dimensional image on a flat screen. This improved
perspective enables depth perception that sharpens the visualization of
the prostate and the network of nerves and tissue surrounding it. Additionally,
by scaling down the motion of the robotic instruments, the surgeon can
perform extremely precise, intricate movements during the procedure. For
example, if the surgeon’s hand moves five centimeters, he/she can
scale the robotic hand to move only one centimeter.

Robotic technology also offers a number of advantages after surgery. Because
laparoscopic surgery is minimally invasive and no large incisions are
involved, robotic-assisted surgery provides numerous benefits for prostate
cancer patients, including: less pain and scarring, diminished blood loss,
a shorter hospital stay and reduced recovery period for a quicker return
to daily activities.

The actual robot consists of a tower that manipulates instruments controlled
from a console that is situated a few feet from the patient. At the console,
the surgeon operates four robotic “arms” and “wrists”
using hand and foot controls. One of the robotic arms holds a tiny video
camera, one works as a retractor and the other two replicate the surgeon’s
exact hand movements. The camera and instruments are inserted through
small keyhole incisions in the patient’s abdomen. The surgeon then
directs the robotic instruments to dissect the prostate gland and surrounding
tissue.

Unlike standard laparoscopic approaches that require counter-intuitive
movements by surgeons (whereby the surgeon must move his hand to the left
in order to move the mechanical device to the right), the robotic technology
affords surgeons the direct, “intuitive” control they exercise
in traditional open surgical procedures, seamlessly translating their
natural hand, wrist and finger movements at the console into corresponding
micro-movements of laparoscopic surgical instruments inside the patient’s
body.

Penn has been using fully robotic surgery for cardiac patients for the
past three years and is currently studying its use for head and neck cancer
surgeries. “The robotic prostate program is a continuation of Penn’s
commitment to finding and applying the most precise, most beneficial surgical
techniques to put patients on a quicker road to recovery with better outcomes,”
said Dr. Lee.

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PENN Medicine is a $2.7 billion enterprise dedicated
to the related missions of medical education, biomedical research, and
high-quality patient care. PENN Medicine consists of the University of
Pennsylvania School of Medicine (founded in 1765 as the nation's first
medical school) and the University of Pennsylvania Health System.

Penn’s School of Medicine is ranked #2 in the nation for receipt
of NIH research funds; and ranked #4 in the nation in U.S. News &
World Report’s most recent ranking of top research-oriented medical
schools. Supporting 1,400 fulltime faculty and 700 students, the School
of Medicine is recognized worldwide for its superior education and training
of the next generation of physician-scientists and leaders of academic
medicine.

The University of Pennsylvania Health System includes: its flagship hospital,
the Hospital of the University of Pennsylvania, consistently rated one
of the nation’s “Honor Roll” hospitals by U.S. News
& World Report; Pennsylvania Hospital, the nation's first hospital;
Penn Presbyterian Medical Center; a faculty practice plan; a primary-care
provider network; two multispecialty satellite facilities; and home health
care and hospice.